Parkinsons - Non Motor Symptoms - 3 Flashcards
what does research show
non motor symptoms can impact QOL in PD
may be as or more significant than motor symptoms in PD
tx that doesnt take into consideration non-motor symptoms
will not succeed
behavioral symptoms (1)
anxiety
depression
a-motivation
apathy
behavioral symptoms (2)
insomnia
impulsivity
obsessive compulsive
symptoms
cognitive symptoms (1)
bradyphrenia
confusion
word finding difficulty
memory loss
cognitive symptoms (2)
dementia
hallucinations
psychosis
other non-motor symptoms
dysautonomia
sensory problems
sleep disorders
weight loss
fatigue
dysautonomia (1)
chills/sweats
orthostatic hypotension
sexual dysfxn
constipation
dysautonomia (2)
urinary frequency and urgency
seborrhea
sialorrhea
sensory problems
pain
paresthesia
anosmia
sleep disorders
REM behavioral
vivid dreams
fatigue
respiratory fxn
pain syndromes
back/neck pain
limb pain
restless leg syndrome
“off” paresthesia
back/neck pain
postural changes & DJD
rigidity, dystonia, dyskinesia
limb pain
cramping
rigidity
dystonia
DJD
where is limb pain most common
in shoulder & proximal arm
restless leg syndrome
common in PD
can be unilateral
painful
relieved by activity or mvt
“off” paranesthesia
sensory changes during “off” period
what % of PD pts have depression
50% of PD pts
primary cause of depression
d/t loss of dopamine neurons
secondary cause of depression
due in part to sensory deprivation from paucity of movement
depression is a
significant contributor to QOL issues
depression responds to
meds
SSRIs
what % of pts have dementia
30-40%
dementia risk
4x higher in PD pts over 3-5 yr period than normal
how do hallucinations begin
by seeing “dots” then becomes “people” or “objects”
what should we be cautious of –> hallucinations
use of meds to tx hallucinations
antipsychotic meds block dopamine
hallucinations can be
very dangerous
increase risk of falls
risk for caregiver burn out
psychosis
dopamine induced psychosis
dopamine induced psychosis features
vivid dreams and nightmares
disorientation
hallucinations
delusional thought
psychosis has an increased rate of
morbidity and nursing home placement
RFs for psychosis
poly-pharmacy
age
dementia
visual problems
what do we tx psychosis with
atypical antipsychotics
increasing cholinergic fxn to improve cognition and behavior
sleep disorders
cant fall asleep
cant stay asleep
dont sleep well
cant fall asleep
RLS
anxiety
motor discomfort
bladder issues
cant stay asleep
depression
REM behavior D/o
bladder issues
anxiety
dont sleep well
REM BD
sleep apnea
potential issues caused by sleep d/o
fatigue
night time safety
motor & behavioral relaxation
caregiver burnout
Gi/GU issues
constipation
urinary problems
constipation worsens w/
decreased exercise and dietary changes
constipation can affect
L-dopa absorption
urinary problems –> urgency and frequency
frequency > urgency
incontinence may need
bladder management/training
what dos urgency increase
falls
what can urinary problems have
dystonia of pelvic floor muscles
what can urinary problems contribute to
decreased volume intake
worsening the orthostatic and constipation sxs
seborrhea
lack of autonomic regulation
leads to increase sebaceous secretions (oily skin)
what could pts develop –> seborrhea
seborrheic dermatitis
